tetano
Editor, Senior Moderator
Acad Pediatr. 2019 Nov 4. pii: S1876-2859(19)30449-8. doi: 10.1016/j.acap.2019.10.015. [Epub ahead of print] [h=1]Centralized Reminder/Recall to Increase Influenza Vaccination Rates: A Two-State Pragmatic Randomized Trial.[/h]
Kempe A[SUP]1[/SUP], Saville AW[SUP]2[/SUP], Albertin C[SUP]3[/SUP], Helmkamp L[SUP]4[/SUP], Zhou X[SUP]5[/SUP], Vangela S[SUP]6[/SUP], Miriam Dickinson L[SUP]7[/SUP], Tseng CH[SUP]8[/SUP], Campbell JD[SUP]9[/SUP], Whittington M[SUP]10[/SUP], Gurfinkel D[SUP]11[/SUP], Roth H[SUP]12[/SUP], Hoefer D[SUP]13[/SUP], Szilagyi P[SUP]14[/SUP].
[h=3]Author information[/h] 1 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO. Electronic address: allison.kempe@childrenscolorado.org. 2 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Alison.saville@CUAnschutz.edu. 3 Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California. Electronic address: Christina_Albertin@URMC.Rochester.edu. 4 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Laura.Helmkamp@CUAnschutz.edu. 5 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: XinkaiZhou@mednet.ucla.edu. 6 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: svangela@mednet.ucla.edu. 7 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Miriam.Dickinson@CUAnschutz.edu. 8 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: CTseng@mednet.ucla.edu. 9 Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: Jon.Campbell@CUAnschutz.edu. 10 Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: Melanie.Whittington@CUAnschutz.edu. 11 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Dennis.Gurfinkel@CUAnschutz.edu. 12 Colorado Immunization Information System, Colorado Department of Public Health and Environment. Electronic address: Heather.Roth@state.co.us. 13 New York State Immunization Information System, New York State Department of Health. Electronic address: Dina.Hoefer@health.ny.gov. 14 Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California. Electronic address: PSzilagyi@mednet.ucla.edu.
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] Centralized reminder/recall (C-R/R) by health departments using Immunization Information Systems (IIS) is more effective and cost-effective than practice-based approaches for increasing childhood vaccines but has not been studied for influenza vaccination. We assessed effectiveness and cost of C-R/R for increasing childhood influenza vaccination compared with usual care.
[h=4]METHODS:[/h] Within Colorado (CO) and New York (NY), random samples of primary care practices (pediatric, family medicine, health center) were selected proportionate to where children are served- 65 practices (N=54,353 children) in CO; 101 practices (N=65,777) in NY. We conducted 4-arm RCTs per state (1, 2 or 3 autodial reminders versus usual care), with randomization at the patient level within practices from 10/2016-1/2017.
[h=4]RESULTS:[/h] In CO, the maximum absolute difference in receipt of ≥1 influenza vaccine was 1.7% between the 2 R/R group and control [adjusted risk ratio (ARR) of 1.06 (1.01, 1.10)]; other R/R arms did not differ significantly. In NY, ARRs for the study arms versus control varied from 1.05 (1.01, 1.10) for 3 R/R to 1.06 (1.01, 1.11) for 1-2 R/R groups and maximum absolute increase in vaccination was 0.6%. In time-to-event analyses, study arm was a significant predictor of vaccination in CO (p=.001) but not in NY. Costs/child randomized to one message were $.17 in CO and $.23 in NY.
[h=4]CONCLUSIONS:[/h] C-R/R for influenza vaccine using autodial had low-level effects on increasing influenza rates in 2 states. Given the feasibility and low cost of C-R/R in previous trials, its utility for influenza should be re-examined using different modalities.
Copyright ? 2019. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Centralized Reminder/Recall; Influenza Vaccine; Population-based Reminder/Recall
PMID: 31698085 DOI: 10.1016/j.acap.2019.10.015
Kempe A[SUP]1[/SUP], Saville AW[SUP]2[/SUP], Albertin C[SUP]3[/SUP], Helmkamp L[SUP]4[/SUP], Zhou X[SUP]5[/SUP], Vangela S[SUP]6[/SUP], Miriam Dickinson L[SUP]7[/SUP], Tseng CH[SUP]8[/SUP], Campbell JD[SUP]9[/SUP], Whittington M[SUP]10[/SUP], Gurfinkel D[SUP]11[/SUP], Roth H[SUP]12[/SUP], Hoefer D[SUP]13[/SUP], Szilagyi P[SUP]14[/SUP].
[h=3]Author information[/h] 1 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO. Electronic address: allison.kempe@childrenscolorado.org. 2 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Alison.saville@CUAnschutz.edu. 3 Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California. Electronic address: Christina_Albertin@URMC.Rochester.edu. 4 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Laura.Helmkamp@CUAnschutz.edu. 5 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: XinkaiZhou@mednet.ucla.edu. 6 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: svangela@mednet.ucla.edu. 7 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Miriam.Dickinson@CUAnschutz.edu. 8 Department of Medicine, Statistics Core, David Geffen School of Medicine, University of California, Los Angeles, California. Electronic address: CTseng@mednet.ucla.edu. 9 Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: Jon.Campbell@CUAnschutz.edu. 10 Department of Clinical Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: Melanie.Whittington@CUAnschutz.edu. 11 Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO. Electronic address: Dennis.Gurfinkel@CUAnschutz.edu. 12 Colorado Immunization Information System, Colorado Department of Public Health and Environment. Electronic address: Heather.Roth@state.co.us. 13 New York State Immunization Information System, New York State Department of Health. Electronic address: Dina.Hoefer@health.ny.gov. 14 Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, California. Electronic address: PSzilagyi@mednet.ucla.edu.
[h=3]Abstract[/h] [h=4]OBJECTIVE:[/h] Centralized reminder/recall (C-R/R) by health departments using Immunization Information Systems (IIS) is more effective and cost-effective than practice-based approaches for increasing childhood vaccines but has not been studied for influenza vaccination. We assessed effectiveness and cost of C-R/R for increasing childhood influenza vaccination compared with usual care.
[h=4]METHODS:[/h] Within Colorado (CO) and New York (NY), random samples of primary care practices (pediatric, family medicine, health center) were selected proportionate to where children are served- 65 practices (N=54,353 children) in CO; 101 practices (N=65,777) in NY. We conducted 4-arm RCTs per state (1, 2 or 3 autodial reminders versus usual care), with randomization at the patient level within practices from 10/2016-1/2017.
[h=4]RESULTS:[/h] In CO, the maximum absolute difference in receipt of ≥1 influenza vaccine was 1.7% between the 2 R/R group and control [adjusted risk ratio (ARR) of 1.06 (1.01, 1.10)]; other R/R arms did not differ significantly. In NY, ARRs for the study arms versus control varied from 1.05 (1.01, 1.10) for 3 R/R to 1.06 (1.01, 1.11) for 1-2 R/R groups and maximum absolute increase in vaccination was 0.6%. In time-to-event analyses, study arm was a significant predictor of vaccination in CO (p=.001) but not in NY. Costs/child randomized to one message were $.17 in CO and $.23 in NY.
[h=4]CONCLUSIONS:[/h] C-R/R for influenza vaccine using autodial had low-level effects on increasing influenza rates in 2 states. Given the feasibility and low cost of C-R/R in previous trials, its utility for influenza should be re-examined using different modalities.
Copyright ? 2019. Published by Elsevier Inc.
[h=4]KEYWORDS:[/h] Centralized Reminder/Recall; Influenza Vaccine; Population-based Reminder/Recall
PMID: 31698085 DOI: 10.1016/j.acap.2019.10.015